Life expectancy at birth
Although based on mortality rates, overall life expectancy is a widely used indicator of health. A major success for the European Region is that life expectancy at birth has increased by 5 years since 1980, reaching 76 years in 2010. This translates to an average annual gain of 0.17 years for the period and, except for two dips around 1984 and 1993, a steady upward increase.
Nevertheless, average life expectancy at birth differs across countries, ranging from 82.2 years to 68.7 years, giving a gap of 13.5 years for 2010 (Fig. 4). Over time, three distinct periods can be noted in terms of inequalities. During the 1980s the highest and lowest levels were converging, showing inequalities across countries narrowing.
Following the mid-1990s, inequalities slowly widened, coinciding with significant social, political and economic change in the eastern part of the Region. Since 2006, the upper and lower extremes have slowly begun to converge again.
80
Life expectancy at birth in the European Region, 1980–2010
(life expectancy at birth (years))
Source: European Health for All database (6).
○ While the population of Europe has grown to nearly 900 million inhabitants, decreasing fertility rates across the Region mean that this trend will soon plateau.
○ The population is ageing rapidly, with projections estimating that more than 25% of the total population of the European Region will be aged 65 and over by 2050.
○ Migration is influencing the demographic transitions observed in Europe.
○ The proportion of the population living in urban areas reached nearly 70% in 2010 and is expected to exceed 80%
by 2045; as a consequence, people are exposed to different health risks and determinants.
Box 2.
Demographic trends – key messages
Life expectancy at birth across the European Region also differs between men and women, highlighting a fundamental and persistent inequality in the Region. In 2010, women’s life expectancy has reached an average of 80 years, while men are living an average of 72.5 years, giving a gap of 7.5 years. Fig. 5 illustrates that, on average, men are lagging behind women in life expectancy by a generation, as in 2010 men had not yet reached the average level women enjoyed in 1980.
There are also larger inequalities across countries for male life expectancy, in comparison to female life expectancy, particularly after 1993.
Large inequalities in average life expectancy at birth are also documented across 46 countries reporting data in 2006–2010 (Fig. 6), with 26 countries above and 20 below the average for the Region.
Inequalities are especially prominent when life expectancy is analysed by sex (Fig. 7). On average, the gap between countries is wider for men (17 years) than women (12 years).
With a few exceptions, inequalities in life expectancy between men and women tend to be widest in countries with lower overall life expectancy levels (for example, below 80 years for women).
The smallest within-country differences by sex (4 years or less) are seen in Iceland, Israel, the Netherlands, Sweden and the United Kingdom, while male–female gaps of 10 years or more occur in Belarus, Estonia, Kazakhstan, Lithuania, Montenegro, the Russian Federation and Ukraine. This suggests that, as countries increase
1985 1995 2005
90 85
75 80
55 67.63
72.63
1985 1995 2005
90 85
60 65
55 75.61
79.94
Males Females
Source: European Health for All database (6).
Fig. 5.
Male and female life expectancy at birth in the European Region, 1980–2010 (life expectancy at birth (years))
their overall life expectancy, they also become more equitable, as the disparities between males and females tend to narrow, potentially challenging the view that there is a static, biological explanation for females having higher life expectancy. Reducing inequalities in life expectancy between men and women requires action on the social determinants of health, including more balanced gender norms, roles and behaviour, which enable men and women equally to obtain the highest standard of health.
60 65 70 75 80 85
Life expectancy at birth (years) SWI ISR ICE ITA SPA SWE SMR MAT AND FRA CYP NOR NET LUX AUT DEU UNK IRE FIN GRE BEL POR SVN DEN CZH CRO EST POL MNE SVK GEO HUN SRB ARM ROM BUL AZE LVA LTU TUR BLR UKR MDA KGZ RUS KAZ
European Region average Fig. 6.
Life expectancy at birth in countries in the European Region, last reported data, 2006–2010
Source: European Health for All database (6).
Source: European Health for All database (6).
60 65 70 75 80 85
Life expectancy at birth (years)
Males Females
KGZMDAKAZTURRUSUKRBLRAZESRBARMROMBULGEOMNELVAHUNLTUSVKCROPOLESTCZHDENIREUNKBELPORSVNGREMATDEUNETAUTNORFINSWELUXICECYPISRSMRANDSWIITAFRASPA
Fig. 7.
Male and female life expectancy at birth in countries in the European Region, last reported data, 2006–2010
Another dimension to compare across countries is the rate of improvement. Fig. 8 documents differences in improvement in life expectancy at birth between 1995 and 2009 in countries. Progress by country in terms of percentage gains during these 14 years varied from less than 1% to more than 10%. The rate of improvement was relatively faster in the eastern and central parts of the European Region than in other areas. Women in France, Italy and Spain gained over 3 years to reach a life expectancy at birth of nearly 85 years: the highest level in the European Region. On average, women in these countries also outlived their countrymen by 5–6 years. In the same period, some countries with lower life expectancy at birth – such as the Czech Republic, Estonia, Hungary, Ireland, Israel, Luxembourg, Poland, Romania, Turkey and the United Kingdom – gained more than 5 years among either men or women. Men in some countries, however, mainly in the eastern part of Europe, lost or had only marginal gains (up to 1.4 years). Nevertheless, even though men have lower absolute levels of life expectancy at birth, they generally had larger proportional gains in 1990–2010 than women.